Medical evaluation for suspected sexual abuse

What is sexual abuse?

Sexual abuse is any sexual contact with a child under the age of 18 years old. It may be:

• Touching private parts
• Kissing, licking, or biting
• Having sex of any kind, including vaginal, oral, or anal
• Making a child view or make pornography
• Sexting or exposing a child to adult sexual activity
• Being given or promised money, drugs, or anything else in exchange for sexual things. This is called sex trafficking.

Most of the time, the abuser is someone the child knows. By law, doctors and nurses must report it to the police when it happens. It is a crime.

Why does my child need a medical exam?

It is important for your child’s health and well-being that their body be checked. Sexual abuse can sometimes cause injuries or other medical problems. Some children feel that their bodies have been damaged by sexual abuse. It can be very helpful for them to hear from a health care provider that their body is healthy and normal or will heal.

Many times, sexual abuse does not leave physical findings. Sometimes injuries heal so well that they can no longer be seen. In most cases, the exam is normal. This does not mean that sexual abuse did not occur. The exam is not meant to prove or disprove what your child has said. Sometimes, exam findings are used as evidence in court.

What happens during the exam?

The medical exam is done in a very child-friendly way. Every child is unique and the staff work hard to help put your child at ease.

Some children want to know everything that is going to happen during the exam. Others would rather be distracted with a book or activity. If your child wants, an advocate or protective parent or caregiver is welcome in the exam room to provide support.

• Questions about your child’s health will be asked.
• A head-to-toe check-up is done.
• A complete check of the genital (outer private parts) and anal areas will be done. A special microscope called a colposcope is used to make the area being checked easier to see. It does not touch your child or cause pain.
• Girls who have not yet had a period will not need an exam inside the vagina. Even girls who have started their periods rarely need an internal exam. The exam is always done in the most comfortable way for your child.
• The exam is often recorded to document any injuries. It is kept very secure. It will not be released unless a judge orders it.
• Urine or blood tests may be done to check for infections. Swabs also may be done by gently wiping the genitals, anus, or throat. The swabs are very small and soft to keep from causing your child any pain.
• Evidence also may be collected this way if the abuse happened recently. Sometimes your child’s clothes may be needed too. If so, your child will be given something else to wear.

What happens after the exam?

• After the exam, the health care provider will:
  • Talk to you about the exam
  • Reassure your child that his or her body is OK. If there is a medical problem, your child will be reassured that it can be treated and their body will heal.
  • Enter information into your child’s medical chart. The police officer or social worker working on the case will have access to the medical report. Your child’s doctor will also have access to the medical report.
• Results from lab tests will be available in about one week. A health care provider will contact you if any result is abnormal.
• Follow-up care visits or referrals will be made, if needed.
• An interview of your child may be needed. This is done by a social worker or police officer with special training.

How do I take care of my child at home after the exam?

• Tell your child that they did a great job during the exam!
• Reassure your child that you support them and will do your best to keep them safe.
• Do not ask your child a lot of questions about the suspected abuse, but do listen if they want to talk about it. A mental health therapist also can be helpful.
• Call your child’s regular doctor with any concerning symptoms:
  • Genital or anal discharge or bleeding
  • Pain in the genital or anal area
  • Behaviors or changes in activity that seem related to the suspected abuse